Extravascular Cells Research Articles

Presence of bone-marrow- and neural-crest-derived cells in intimal hyperplasia at the time of clinical in-stent restenosis.

Intralesional data of coronary target lesions following stent implantation are infrequent. In addition, there is ongoing controversy on the origin of neointimal cells. In this respect, several lines of evidence revealed bone-marrow-derived endothelial progenitor and dendritic cells (DCs) as well as neural-crest-derived cells (NCCs) to contribute to atherosclerosis. Therefore, the objective of the present study was to assess cellularity, cell type and origin of neointimal cells in in-stent restenosis (ISR). Atherectomy specimens from 17 patients with coronary in-stent restenosis (n=10; time post-stenting 5+/-3 months) and with peripheral in-stent restenosis (n=7; 7+/-3 months) versus those from 10 patients with primary lesions were immunohistochemically examined for the presence of the determinants CD34, AC133, S100, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), nerve growth factor receptor (NGFR) and alpha-smooth muscle actin followed by computer-assisted morphometry. In-stent restenosis probes consistently demonstrated homogeneous hypercellularity (942+/-318 cells/mm(2)) compared to de novo lesions (347+/-120 cells/mm(2), P<0.001). alpha-smooth muscle actin positive cells occupied 67% of intimal cells in in-stent restenosis. As a key finding, expression of endothelial progenitor cells (CD34: 7.1+/-2.5% positive/total cells vs. 0.6+/-0.7%, P<0.001; AC133: 7.0+/-3.4% vs. 1.0+/-0.7%, P<0.001), dendritic cells (S100: 9.8+/-5.6% vs. 1.4+/-1.1%, P<0.001) and neural-crest-derived cells (GFAP: 7.9+/-2.4% vs. 3.1+/-1.0%; NSE: 4.4+/-2.6% vs. 1.3+/-1.6%; NGFR: 4.2+/-2.5% vs. 1.1+/-0.7%; each P<0.001) was significantly increased in in-stent restenosis compared to primary lesions. Bone-marrow- and neural-crest-derived cells, the most dendritic cells, are consistently present in in-stent restenosis, whereas alpha-smooth muscle actin positive cells constitute the largest intimal cell pool. Our data suggest the recruitment of primarily extravascular cells within neointima formation in human in-stent restenosis.

Endothelial responses to bacterial toxins in sepsis.

The virulence of pathogenic bacteria is critically dependent on their ability to produce toxins that attack eukaryotic target cells. Microbial toxins are either structural components of the bacterial cell wall (endotoxins) or actively secreted proteins (exotoxins). Sepsis and septic shock, which represent major causes of mortality in modern intensive care medicine, are caused by an inadequate inflammatory and immunological host response to bacterial infection. Emerging evidence suggests that the systemic spread of microbial toxins, rather than bacteremia itself, is the crucial event in the pathogenesis of this dramatic dysregulation. The endothelium, with its diversity of physiological functions is a main target of bacterial toxins. The resulting endothelial dysfunction is believed to contribute to the underlying pathomechanisms and the collapse of homeostasis of organ function. In vitro, bacterial toxins induce subtle alterations of endothelial cell function rather than massive cell damage. Furthermore, bacterial toxins targeting endothelial cells severely alter the behavior of extravascular cells and circulating leukocytes via excessive formation of vasoactive mediators and overexpression of adhesion molecules. Research on the effects of microbial toxins on vascular endothelium has broadened our general understanding of microbial strategies to induce organ damage, even in the absence of viable bacteria. Combining antitoxin strategies with antibiotic therapy may prove to be of benefit to patients suffering from bacterial sepsis in the future.

Finding Extravascular Red Blood Cells (RBC's) in Hematoxylin and Eosin Sections

Finding Extravascular Red Blood Cells (RBC's) in Hematoxylin and Eosin Sections

The blood platelet as a model for regulating blood coagulation on cell surfaces and its consequences.

Platelets actively participate in regulating thrombin production following physical or chemical injury to blood vessels. Injury to blood vessels initiates activation of the large numbers of platelets that appear in the subendothelium where they become exposed to tissue factor and to molecules adhesive for platelets and normally found in the extracellular matrix. The complex of plasma factor VIIa with extravascular tissue factor both initiates and localizes thrombin production on platelets and on extravascular cells. Thrombin production at these sites in turn enhances platelet activation and the subsequent hemostatic plug formation to minimize bleeding. Thrombin production and platelet activation also initiate the process of wound healing requiring thrombin-dependent cell activation and platelet-dependent formation of new blood vessels (angiogenesis). Activated platelets release from their storage granules several proteins and other factors that regulate local thrombin formation and the responses of blood vessel cells to injury to assure hemostasis and effective wound healing. Failure to localize and adequately regulate thrombin production and/or platelet activation can have pathological consequences, including the development and propagation of atherosclerosis and enhancement of tumor development. The primary basis for the pathological consequences of the failure to adequately regulate thrombin production is that the multi-functional thrombin activates several types of cells to initiate their mitogenesis. Mitogenesis precedes many of the undesirable consequences of poorly regulated thrombin production and platelet activation. In addition, activated platelets release a variety of products which influence the functions of several cell types to the extent that inadequate regulation of platelet activation (by excessive thrombin production) could contribute to the pathogenesis of acute and chronic arterial thrombosis and to tumor development. Activated platelets participate in tumor development by releasing several factors that positively (and negatively) regulate blood vessel formation.

Alcoholism, hypercortisonism, fat embolism and osseous avascular necrosis. 1971.

Alcoholism, hypercortisonism, fat embolism and osseous avascular necrosis. 1971.

Cocaine-induced midline destructive lesions: clinical, radiographic, histopathologic, and serologic features and their differentiation from Wegener granulomatosis.

Cocaine-induced midline destructive lesions: clinical, radiographic, histopathologic, and serologic features and their differentiation from Wegener granulomatosis.

An Extensive System of Extravascular Smooth Muscle Cells Exists in the Choroid of the Rabbit Eye

We investigated the structural organization of the choroid especially with regard to the presence of extravascular smooth muscle (EVSM) cells in albino rabbits. The eyes were fixed by intracardiac perfusion and processed for light, confocal, and electron microscopy. An unlabeled monoclonal antibody against α-actin of smooth muscle and a horseradish-peroxidase-conjugated secondary antibody were used for immunodetection of smooth muscle actin by light microscopy. For confocal microscopy, whole mount choroids were immunostained with a fluorescein isothiocyanate-conjugated (FITC) antibody. Our investigations revealed that the choroidal vessels are enveloped by bundles of EVSM. In contrast to the circular orientation of the smooth muscle cells of the tunica media of the choroidal vessels, the cells of the EVSM system were oriented longitudinally along the external surface of the vessel wall. The EVSM cells were strongly immunopositive for smooth muscle α-actin and exhibited a green fluorescence of the FITC-labeled anti-α-actin antibody. Individual cells were elongated and spindle-shaped, had the usual ultrastructural features of smooth muscle cells and, in places, were organized as 20 layers. EVSM cells were present throughout the thickness of the choroid, but not between the fenestrated endothelial lining of the choriocapillaris and Bruch’s membrane, and extended from the optic nerve to the ciliary body where they merged with the ciliary muscles. Based on the three dimensional organization, immunoreactivity, and cellular and subcellular features of the EVSM system as well as information in the literature, we hypothesize that, functionally, this system, in conjunction with the choroidal vasculature, contributes to the myogenic control of choroidal blood flow and tissue volume, and also affects the intraocular pressure as well as the refractive and accommodative state of the eye.

Effects of mechanical stimulation on cell cycle duration in rat gingival fibroblast progenitor cells.

The aim of this investigation was to estimate cell cycle duration in rat gingival fibroblast progenitor cells in steady-state control and during sustained mechanical stimulation. Elastics (0.15 mm thick) were inserted between maxillary M1 and M2 of 8 wk-old male rats which were labelled with H3-TdR and killed in groups of 6-7 animals together with equal-sized groups of labelled control animals at intervals between 1-168 h. Autoradiographs of consecutive mesio-distal sections were used to determine grain counts for H3-TdR-labelled cells in the connective tissue of the gingival papilla between M2 and M3. Median cell cycle times (MCC) were estimated from plots of mean and median grain counts against time. Under steady-state conditions, MCC for heavily-labelled and lightly-labelled paravascular cell populations and for labelled extravascular cells were 144, 76 and 50 h, respectively. Mechanical stimulation caused a significantly faster rate of reduction of total grain counts relative to controls in all three cell populations and a decline of estimated MCC to 115, 50 and 21 h in heavily labelled and lightly labelled paravascular cells and labelled extravascular cells, respectively. These findings indicate that mechanical stimulation induces faster progression of gingival fibroblast progenitor cells through the cell cycle.

Dermal cellular inflammation in burns. an insight into the function of dermal microvascular anatomy

The damage caused by thermal trauma is augmented by the subsequent inflammatory response in a similar fashion to reperfusion injury. Animal studies have demonstrated a significant role for neutrophils in this delayed damage, but little is known about the numbers of neutrophils or other leucocytes that enter human skin following burns. We have longitudinally examined profiles of leucocyte migration into five cases of human partial thickness burns in relation to continued dermal microvascular destruction during the acute post-burn period. All burn wounds had a rapid influx of neutrophils that was followed by a delayed influx of macrophages. Compared to the controls, the two superficial burns also had rapid and sustained influx of CD4 and CD8 lymphocytes via patent post capillary venules in the dermal superficial vascular plexus, whilst in the three deeper burns, in which this superficial vascular plexus was occluded, the number of lymphocytes decreased. These results suggest that the patterns of leucocyte extravasation were dependent on the initial level of vascular occlusion, indicating that the dermal microvascular anatomy plays a pivotal role in determining the composition of the extravascular inflammatory cell infiltrates. The potential importance of this finding is highlighted by the differences in wound behaviour associated with the different leucocyte profiles.

Structure and Biology of Tissue Factor Pathway Inhibitor

Human tissue factor pathway inhibitor (TFPI) is a modular protein comprised of three Kunitz type domains flanked by peptide segments that are less structured. The sequential order of the elements are: an N-terminal acidic region followed by the first Kunitz domain (K1), a linker region, a second Kunitz domain (K2), a second linker region, the third Kunitz domain (K3), and the C-terminal basic region. The K1 domain inhibits factor VIIa complexed to tissue factor (TF) while the K2 domain inhibits factor Xa. No direct protease inhibiting functions have been demonstrated for the K3 domain. Importantly, the Xa-TFPI complex is a much more potent inhibitor of the VIIa-TF than TFPI by itself. Furthermore, the C-terminal basic region of TFPI is required for rapid physiologic inhibition of coagulation and is needed for the inhibition of smooth muscle cell proliferation. Although a number of additional targets for attachment have been reported, the C-terminal basic region appears to play an important role in binding of TFPI to cell surfaces. A primary site of TFPI synthesis is endothelium and the endothelium-bound TFPI contributes to the antithrombotic potential of the vascular endothelium. Further, increased levels of plasma TFPI under septic conditions may represent endothelial dysfunction. We have proposed that the extravascular cells that synthesize TF also synthesize TFPI providing dual components necessary for the regulation of clotting in their microenvironment. Like the TF synthesis in these cells is augmented by serum, so is the case with the TFPI gene expression. TFPI gene knock out mice reveal embryonic lethality suggesting a possible role of this protein in early development. Since TF-induced coagulation is thought to play a significant role in many disease states, including disseminated intravascular clotting, sepsis, acute lung injury and cancer, recombinant TFPI may be a beneficial therapeutic agent in these disease states to attenuate pathologic clotting. The purpose of this review is to outline recent developments in the field related to the structural specificity and biology of TFPI.

Cell surface heparan sulfate proteoglycans and lipoprotein metabolism.

Cell surface heparan sulfate proteoglycans are involved in several aspects of the lipoprotein metabolism. Most of the biological activities of these proteoglycans are mediated via interactions of their heparan sulfate moieties with various protein ligands, including lipoproteins and lipases. The binding of lipoproteins to heparan sulfate is largely determined by their apoprotein composition, and apoproteins B and E display the highest affinity for heparan sulfate. Interactions of lipoproteins with heparan sulfate are important for the cellular uptake and turnover of lipoproteins, in part by enhancing the accessibility of lipoproteins to lipoprotein receptors and lipases. Apoprotein B may interact with receptors without involving heparan sulfate. Heparan sulfate has been further implicated in presentation and stabilization of lipoprotein lipase and hepatic lipase on cell surfaces and in the transport of lipoprotein lipase from extravascular cells to the luminal surface of the endothelia. In atherosclerosis, heparan sulfate is intimately involved in several events important to the pathophysiology of the disease. Heparan sulfate thus binds and regulates the activity of growth factors, cytokines, superoxide dismutase and antithrombin, which contribute to aberrant cell proliferation, migration and matrix production, scavenging of reactive oxygen radicals and thrombosis. In this review we discuss the various roles of heparan sulfate proteoglycans in vascular biology, with emphasis on interactions of heparan sulfate with lipoproteins and lipases and the molecular basis of such interactions.

Fibroblasts, glial, and neuronal cells are involved in extravascular prothrombin activation.

A membrane-associated prothrombin activator (MAPA) was found on various cultured cells derived from non-hematopoietic cells [Sekiya, F. et al. (1994) J. Biol. Chem. 269, 32441-32445]. In this study, we investigated the enzymatic properties of this enzyme using protease inhibitors. While the metalloproteinase inhibitor, o-phenanthroline, had no effect, some Kunitz type serine protease inhibitors attenuated MAPA activity. Recombinant tissue factor pathway inhibitor (rTFPI) also markedly reduced the activity (IC(50), 1. 3+/-0.6 x 10(-10) M). MAPA activity is, therefore, most likely to be due to factor Xa. We evaluated the effect of exogenous factor Xa on MAPA activity. Factor Xa-dependent prothrombin activation was observed on fibroblast cells (apparent K(d), 1.47+/-0.72 nM). Activation was also observed on glial and neuronal cells, which expressed MAPA activity. These results imply that membrane-bound factor Xa results in MAPA activity on these cells. Therefore, we considered the involvement of factor Va, a component of prothrombinase, in this activity. We examined whether or not the prothrombinase complex is assembled on these cells. Prothrombin was activated in a manner dependent on both exogenous factor Xa and factor Va (apparent K(d) of 0.51-1.81 nM for factor Va). These results indicate that the prothrombinase complex forms specifically on various extravascular cells. Although the prothrombinase complex can be assembled on monocytes and lymphocytes, it is not known why these cells can activate prothrombin specifically. These cells which have the capacity for prothrombin activator activity could also activate factor X; i.e. cells with factor X activation activity were able to convert prothrombin. These observations suggest that thrombin was generated via two procoagulant activities; factor X activation and subsequent prothrombinase complex formation on the surface of these cells. This mechanism may explain the various pathological states involving or resulting from extravascular thrombin and fibrin formation.

Endothelial cell function and thrombosis

The endothelium is pivotal in the control of haemostasis and thrombosis because it is the primary source of many of the major haemostatic regulatory molecules. Healthy endothelial cells, unlike extravascular cells, are anticoagulant and antithrombotic. This is due to the regulated secretion of antiplatelet agents, including prostacyclin and nitric oxide. Following vessel injury, platelet adhesion to exposed matrix requires von Willebrand Factor, another endothelial cell product. Local generation of thrombin causes a series of receptor-mediated endothelial cell functional responses, while the surface of the endothelium is additionally the site for inactivation of thrombin by antithrombin, and its conversion to a coagulation inhibitor by interaction with thrombomodulin. Endothelial cells are also the source of circulating tissue-type plasminogen activator and its inhibitor, and Tissue Factor pathway inhibitor. In disease states, many of these endothelial cell properties are perturbed towards a more procoagulant and prothrombotic phenotype.

Local neovascularization and cellular composition within vulnerable regions of atherosclerotic plaques of human carotid arteries.

An improved immunohistochemical method has been used to assess neovascularization within the vulnerable 'shoulder' regions of atherosclerotic plaques from carotid arteries. A combination of monoclonal antibodies (CD31, CD34, +/- von Willebrand factor) was shown to be far more effective than conventional techniques in demonstrating extensive vascularizations within the 'shoulder' and cap regions of late-stage plaques. Such sites were shown to be microfocal, often appearing as a plexus of both large and small vessels which occupied a significant proportion of the 'shoulder' area. These regions of marked neovascularization were commonly associated with accumulations of macrophages, mast cells, and T-cells, indicative of local inflammatory reactions. The matrix components elastin and collagen type VI showed variable distributions which suggested extensive tissue remodelling, whereas collagen type IV was recognized as a basement membrane protein of most blood vessels, as well as being associated with 'stellate' smooth muscle cells. Evidence of local microvascular damage within the shoulder regions of some specimens was demonstrated by extravascular red blood cells, macrophages containing haemosiderin, and perivascular fibrin deposition. These local haemorrhages derived from microvessels beneath the lining of the arterial lumen are a further indication of how the microfocal vascularization of the plaque 'shoulder' might contribute to further complications of inflammation and plaque destabilization in late-stage disease.

Local neovascularization and cellular composition within vulnerable regions of atherosclerotic plaques of human carotid arteries

An improved immunohistochemical method has been used to assess neovascularization within the vulnerable ‘shoulder’ regions of atherosclerotic plaques from carotid arteries. A combination of monoclonal antibodies (CD31, CD34, ± von Willebrand factor) was shown to be far more effective than conventional techniques in demonstrating extensive vascularizations within the ‘shoulder’ and cap regions of late-stage plaques. Such sites were shown to be microfocal, often appearing as a plexus of both large and small vessels which occupied a significant proportion of the ‘shoulder’ area. These regions of marked neovascularization were commonly associated with accumulations of macrophages, mast cells, and T-cells, indicative of local inflammatory reactions. The matrix components elastin and collagen type VI showed variable distributions which suggested extensive tissue remodelling, whereas collagen type IV was recognized as a basement membrane protein of most blood vessels, as well as being associated with ‘stellate’ smooth muscle cells. Evidence of local microvascular damage within the shoulder regions of some specimens was demonstrated by extravascular red blood cells, macrophages containing haemosiderin, and perivascular fibrin deposition. These local haemorrhages derived from microvessels beneath the lining of the arterial lumen are a further indication of how the microfocal vascularization of the plaque ‘shoulder’ might contribute to further complications of inflammation and plaque destabilization in late-stage disease. Copyright © 1999 John Wiley & Sons, Ltd.

Cadherin-5 redistribution at sites of TNF-alpha and IFN-gamma-induced permeability in mesenteric venules.

The response of the endothelial permeability barrier in microvascular networks of the rat mesentery to perfused immune inflammatory cytokines tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) was examined. TNF-alpha (12.5 U/ml) treatment did not change albumin permeability, but in combination with IFN-gamma (20 U/ml), there was a marked increase in the number of sites of extravascular albumin in postcapillary venules. Endothelial integrity was characterized by cadherin-5 immunoreactivity, which was localized to the continuous intercellular junctions of endothelium in arterioles, capillaries, and venules. Perfusion with the combined cytokines showed that the increased albumin permeability was dose dependent and correlated with the focal disorganization of cadherin-5 at intercellular junctions of venular endothelium. No correlation was found between the increase in albumin permeability and the localization of intravascular leukocytes or extravascular mast cells. These results show that the combination of TNF-alpha and IFN-gamma induces an endothelial phenotype with focal loss of cadherin-5 intercellular adhesion, which, in part, facilitates passage of blood macromolecules and cells to the interstitium.

Putative role of extravascular stromal cells in the regulation of human placental blood flow

Putative role of extravascular stromal cells in the regulation of human placental blood flow

Carbon dioxide and the cerebral circulation.

Carbon dioxide and the cerebral circulation.

Embryonic CNS macrophages and microglia do not stem from circulating, but from extravascular precursors

Invasion of mesoderm-derived cells into the developing spinal cord and brain has been shown to produce early central nervous system (CNS) macrophage and microglia populations in avian embryos. A triplicate mode of entry has been proposed: through the endothelial wall of CNS blood vessels; from the ventricular cavities; and through the pial surface. Invasion of circulating blood cells (monocytes) has not yet been proved in embryonic CNS. This report demonstrates: 1) the use of chick-quail blood chimeras by way of parabiosis (two embryos in one egg); 2) the use of QH1 monoclonal antibody for detection of quail cells circulating in chick blood vessels; 3) the presence of extravascular QH1-positive cells (macrophages) in E7-10 CNS in parabiosis quail, and their absence in parabiosis chick. We conclude that avian macrophages/microglia precursors do not penetrate through the wall of embryonic CNS vessels. In combination with published results, this finding strongly supports the view that invasion of migratory macrophages from the pial surface and proliferation inside the CNS generate all microglia in avian embryos.

Molecular anatomy of the perivascular sheath in human placental stem villi: the contractile apparatus and its association to the extracellular matrix.

In previous studies, we have shown that smooth muscle cells and myofibroblast subpopulations of the perivascular stem villous sheath of the human placenta contain focal adhesion plaques and talin immunoreactivity. The close association of these cells to elastic and collagen fibres have led to the assumption of a functional myofibroelastic unit within the perivascular stem villous sheath. Interactions between the extracellular matrix and smooth muscle cells depend on a variety of structural protein assemblies. In the present study, we examined, by immunocytochemistry, whether the molecular assembly of extracellular matrix proteins and molecules of focal adhesions, known to be essential for signal transduction in smooth muscle cells, are also found in smooth muscle cells of the perivascular stem villous sheath of the human placenta. Vascular and extravascular smooth muscle cells were immunoreactive for alpha-actinin, vinculin, paxillin and tensin, the integrin chains alpha1 and beta1, and the basement membrane components laminin and heparan/-chondroitin sulfate proteoglycan perlecan. pp125(FAK) did not react. In the extracellular matrix of blood vessel walls and the perivascular stem villous sheath, we found immunoreactivity of fibronectin and collagen types I, VI and undulin (collagen type XIV). From our data we conclude that within the perivascular stem villous sheath, there exists a system of signal transduction molecules, indicating a cross talk between the smooth muscle cells of this sheath and their surrounding extracellular matrix.